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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Friday, February 10, 2012
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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Friday, February 10, 2012
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Sleep Disorders |
Bedwetting01/04/2007 |
Is there a condition to describe a child who sleeps deep and wets his bed 2-3 times per night? If this is the case, what can be done to correct this situation? Boy is nine.
You are describing a child with what is called sleep-related enuresis, which is involuntary urination during sleep at an age by which volitional control is usually expected i.e. 5 years of age. Sleep-related enuresis occurs in about 10% of 6 year olds decreasing to about 3% of 12 year olds. There is a family disposition with the highest incidence occurring in children whose parents were both enuretic during childhood.If the child has never been dry at night for more than 3 months the condition is referred to as primary enuresis, which is the most common type. Secondary enuresis is nighttime urination that redevelops in a child who was previously dry during sleep for at least 3 months. A careful history should be taken for other nighttime symptoms that could signal another sleep disorder that is contributing to the bedwetting, such as snoring, frequent leg movements or unusual movements at night. Prior urinary tract infections and difficulty with urination, including daytime urgency or frequency of urination, are also important in the history.
The exact mechanism that explains the cause of sleep-related enuresis has not yet been discovered. It is considered a disorder of arousal in which the enuretic child fails to awaken during episodes of bedwetting. Enuresis can be treated after a careful evaluation to determine if there is a potential cause of the problem (such upper airway obstruction) that may need specific therapy. If not, then interventions geared towards the bedwetting can be tried.
Non-medication interventions may include beeper systems worn at night that can result in remission rates of 50-70%. Medications can also be used with some children being treated with a bedtime oral dose of DDAVP, a synthetic analog of a hormone controlling body water excretion. This therapy helps in 60-75% of children. Response with DDAVP is rapid, often within a week.
I recommend you discuss your child's problem with his pediatrician. They will gather additional information and determine if any testing is needed or a trial of treatment can be performed.
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Mark Splaingard, MD Professor, Clinical Pediatrics Pulmonary Medicine Nationwide Children’s Hospital College of Medicine The Ohio State University |
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